Abstract
Positive findings on capsule endoscopy (CE) often prompt a follow-up procedure with therapeutic intent. Our purpose was to review the therapeutic yield of subsequent procedural interventions based on positive CE findings. The medical records of all patients who underwent CE between June 2002 and February 2005 for obscure bleeding were retrospectively reviewed. Fifty-two patients had follow-up procedures based on positive capsule findings. In this group, angiodysplasia was the most common CE finding (n=30), with therapeutic intervention performed in 16 cases (53%). Fresh blood without clear lesion was the second most common finding (n=9), with therapeutic intervention performed in 6 cases (67%). Overall, a therapeutic intervention was performed in 33 of the 52 follow-up procedures (63%). Positive capsule findings directed further procedural investigation in 52 cases, with a high therapeutic yield of 63% in those cases. The long-term efficacy of such interventions warrants further investigation.
Similar content being viewed by others
References
Zuckerman GR, Prakash C, Askin MP, Lewis BS (2000) AGA technical review on the evaluation and management of occult and obscure gastrointestinal bleeding. Gastroenterology 118:201–221
Lewis BS, Swain P (2002) Capsule endoscopy in the evaluation of patients with suspected small intestine bleeding: results of a pilot study. Gastrointest Endosc 56:349–353
Scapa E, Jacob H, Lewcowicz S, Migdal M, Gat D, Gluckhovski A, Gutmann N, Fireman Z (2002) Initial experience of wireless-capsule endoscopy for evaluating occult gastrointestinal bleeding and suspected small bowel pathology. Am J Gastointestinal 97:2776–2779
Maieron A, Hubner D, Blaha B, Deutsch C, Schickmair T, Ziachehabi A, Kerstan E, Knoflach P, Schoefl R (2004) Multicenter retrospective evaluation of capsule endoscopy in clinical routine. Endoscopy 36:864–868
Enns R, Go K, Chang H, Pluta K (2004) Capsule endoscopy: a single-centre experience with the first 226 capsules. Can J Gastroenterol 18:555–558
Saurin JC, Delvaux M, Gaudin JL, Fassler I, Villarejo J, Vahedi K, Bitoun A, Canard JM, Souquet JC, Ponchon T, Florent C, Gay G (2003) Diagnostic value of endoscopic capsule in patients with obscure digestive bleeding: blinded comparison with video push enteroscopy. Endoscopy 35:576–584
Mata A, Bordas JM, Feu F, Gines A, Pellise M, Fernandez Esparrach G, Balaguer F, Pique JM, Liach J (2004) Wireless capsule endoscopy in patients with obscure gastrointestinal bleeding: a comparison study with push enteroscopy. Aliment Pharmacol Ther 20:189–194
Pennazio M, Santucci R, Rondonotti E, Abbiati C, Beccari G, Rossini FP, DeFranchis R (2004) Outcomes of patients with obscure gastrointestinal bleeding after capsule endoscopy: report of 100 consecutive cases. Gastroenterology 126:643–653
Rastogi A, Schoen RE, Slivka A (2004) Diagnostic yield and clinical outcomes of capsule endoscopy. Gastrointest Endosc 60:959–964
Iddan G, Meron G, Glukhovsky A, Swain P (2000) Wireless capsule endoscopy. Nature 415:417
Chak A, Koehler MK, Sundaram SN, Cooper GS, Canto MI, Sivak MV Jr (1998) Diagnostic and therapeutic impact of push enteroscopy: analysis of factors associated with positive findings. Gastrointest Endosc 47:18–22
Selby W (2004) Can clinical features predict the likelihood of finding abnormalities when using capsule endoscopy in patients with GI bleeding of obscure origin? Gastrointest Endosc 59:782–787
Graham DY, Opekun AR, Willingham FF, Qureshi WA (2005) Visible small bowel mucosal injury in chronic NSAID users. Clin Gastroenterol Hepatol 3:55–59
Goldstein JL, Eisen GM, Lewis B, Gralnek IM, Zlotnick S, Fort JG (2005) Video capsule endoscopy to prospectively assess small bowel injury with celecoxib, naproxen plus omeprazole, and placebo. Clin Gastroenterol Hepatol 3:133
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Baichi, M.M., Arifuddin, R.M. & Mantry, P.S. Capsule Endoscopy for Obscure GI Bleeding: Therapeutic Yield of Follow-up Procedures. Dig Dis Sci 52, 1370–1375 (2007). https://doi.org/10.1007/s10620-006-9542-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10620-006-9542-1